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PulseConnect Registration Form

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CDCES CMA CNM DO DTR LDN LPN MD MPH ND MS NP PA PhD PharmD RD/RDN/LDN/CDN RN/APRN RPh Other

What best describes your primary specialty?

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How many people do you counsel, coach or advise per week?

On which of the following topics do you regularly counsel patients or clients?

Which of the following do you use for your professional work and/or to share health and wellness information?

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What percentage of your patients or clients are Spanish-only speakers/readers?

What percentage of your patients or clients qualify for/are on WIC?

How do you see patients?

Both in person & virtually In person Virtually